Archive for April, 2013


IPAB Again Under Fire

The advisory board created by the Affordable Care Act to help control rising Medicare costs is again the target of critics advocating its abolition.

This time, more than 500 groups have sent a joint letter to Congress, urging it to abolish the as-yet unformed Independent Payment Advisory Board (IPAB).

This latest letter, from the Healthcare Leadership Council, charges that the board will limit access to care for Medicare beneficiaries and have the authority to reverse laws passed by Congress.

Read more about the issue and find a link to the letter itself here, on the Fierce Healthcare web site.…

Medicaid Expansion Would Boost PA’s Economy and Save Money, New Report Says

Expanding Medicaid eligibility as envisioned in the Affordable Care Act would boost the state’s economy and save state government money, according to a new study.

In the report “Economic and Fiscal Impact of Medicaid Expansion in Pennsylvania,” the Pennsylvania Economy League and the PA Health Funders Collaborative concluded that Medicaid expansion in the state would generate $4.4 billion in state government savings, bring $32 billion of new federal government money into the state’s economy, support as many as 40,000 new jobs and $3.6 billion in new tax revenue, and have a positive fiscal impact of more than $5 billion.

Read the entire report here, on the web site of the Pennsylvania Economy League.…

Hospitals Ratchet Up Advocacy of Medicaid Expansion

Hospitals across the country are working with other interest groups to attempt to persuade their state governments to expand their Medicaid programs as envisioned in the Affordable Care Act.

Some states still have not decided whether they will expand, and in a few states where governors have indicated their desire to do so, state legislators are opposing such action.

Among the arguments that advocates of Medicaid expansion are making are that expansion will bring huge amounts of new federal money to their state; that it will help people who currently lack reasonable access to care; and that it will help stabilize hospitals’ financial condition.

Read more about this latest round of Medicaid expansion advocacy, the people behind it, and what they are doing to try to change people’s minds in this Stateline article.…

Medicaid Caps Per Enrollee?

Would limiting state Medicaid spending per enrollee help control Medicaid costs or would it just leave the states with a bigger proportion of Medicaid spending?

How might such an approach differ from Medicaid block grants, another mechanism for controlling rising Medicaid costs that has been proposed in recent years?

The Robert Wood Johnson Foundation and the publication Health Affairs have prepared a policy brief on Medicaid per capita caps – how they might work, what the advantages and disadvantages might be, and how they differ from Medicaid block grants.  Find the paper, “Per Capita Caps in Medicaid,” here on the web site of the Robert Wood Johnson Foundation.…

New Study Draws Distinction Between Patient Satisfaction and Quality of Care

A happy patient may not necessarily be a well cared-for patient and an unhappy patient could be receiving excellent care, according to a new study.

The Journal JAMA Surgery reports that there is little relationship between the satisfaction hospital patients express about their surgical experiences and the quality of care they received.

In the April 2013 article “Patient Satisfaction as a Possible Indicator of Quality Surgical Care,” the study’s authors wrote that

Patient satisfaction was independent of hospital compliance with surgical processes of quality care and with overall hospital employee safety culture, although a few individual domains of culture were associated.  Patient satisfaction may provide information about a hospital’s ability to provide good service as part of the patient experience; however, further study is needed before it is applied widely to surgeons as a quality indicator.

The results of patient satisfaction surveys are an important factor in determining payments to hospitals under Medicare’s value-based purchasing program.  The JAMA Surgery study appears to call into question the appropriateness of such an approach.

Read a Kaiser Health News report on the JAMA Surgery article here and find the complete article here.…